Successful caudal vena cava and pulmonary vein isolation in healthy horses using 3D electro-anatomical mapping and a contact force-guided ablation system.
Authors: Buschmann Eva, Van Steenkiste Glenn, Duytschaever Mattias, Boussy Tim, Vernemmen Ingrid, Ibrahim Lara, Schauvliege Stijn, Decloedt Annelies, van Loon Gunther
Journal: Equine veterinary journal
Summary
# Editorial Summary Atrial arrhythmias remain a significant clinical challenge in equine practice, with myocardial sleeves extending into the caudal vena cava and pulmonary veins identified as potential ectopic foci in both atrial tachycardia and atrial fibrillation cases. This Belgian research team applied three-dimensional electro-anatomical mapping combined with contact force-guided radiofrequency catheter ablation to systematically isolate these arrhythmogenic zones in six healthy horses, utilising advanced cardiac imaging to guide precise lesion placement. Successful electrical isolation of both the caudal vena cava and pulmonary vein myocardial sleeves was achieved in all animals, with no serious procedural complications reported and maintained isolation confirmed at follow-up assessment. These findings represent a significant refinement of catheter ablation techniques in equine cardiology, potentially offering a definitive treatment pathway for horses with recurrent or refractory atrial arrhythmias that fail to respond to conventional pharmaceutical management. For practitioners managing performance horses or those with documented arrhythmias, this work suggests that referral for specialist electrophysiology assessment may warrant consideration earlier in the diagnostic pathway, particularly where medical management has proven ineffective or where maintaining athletic function is paramount.
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Practical Takeaways
- •3D EAM-guided RFCA offers a novel interventional approach for treating equine atrial arrhythmias that may be refractory to medical management
- •This technique requires specialized equipment and expertise; referral to tertiary centres with catheterization capabilities is necessary for appropriate candidate selection
- •Successful isolation of myocardial sleeves in pulmonary and caval veins may improve outcomes in horses with atrial fibrillation or tachycardia
Key Findings
- •3D electro-anatomical mapping and radiofrequency catheter ablation can successfully isolate myocardial sleeves in the caudal vena cava and pulmonary veins in healthy horses
- •Contact force-guided ablation system enables precise targeting of arrhythmogenic tissue
- •Myocardial sleeves in caudal vena cava and pulmonary veins are identified as potential triggers for atrial tachycardia and atrial fibrillation in horses